Palatable

Food must be at the right temperature for each person. At end of life, patients can develop unusual tastes, for example, wanting spicier food or preferring a meal cold. The skills of an enthusiastic chef and the advice of a dietitian should help with this.

Food should be what the person fancies, it can be helpful to add cream/butter to the food to add calories.

Ensure you understand the needs of the person

Food, and the service of food, is now regarded as an essential part of treatment, meaning that the actual preparation of food for the patient is also of great importance. The need for a greater understanding in the importance of the patient meal experience and nutritional requirements is increasing.

Decisions

When making decisions about the nutrition and hydration needs of a patient it’s important to realise that every situation is different and rigid policies are hard to follow. Decisions must be made in a person’s best interests if they are without the capacity to make decisions about their nutrition or hydration.

Monitor and review any nutritional intervention and care plan.

Reassess continually to ensure your patient is not at nutritional risk.

Observing your patient will ensure that you notice any changes in their appetite or ability to eat and drink.

Effective record keeping will ensure that any subtle changes in your patient’s condition are monitored and changes in their nutrition and hydration care plan can be made as required.

Support your patient by helping them to eat or drink.

Making changes

Any changes in nutrition and hydration should be done sensitively and at all times keep the patient and relatives informed of decisions made and the reasons why this approach has been taken.

Many relatives and carers may think withholding fluid or nutrition will cause distress to the patient. For example, the removal of a water jug from beside the patient because they are unable to drink from a beaker can be distressing for relatives. It can be seen as a withdrawal of care, and sometimes relatives or carers will continue to request for hydration. You must explain sensitively why the hydration using this method has been withdrawn and how it has been replaced.